Efficacy and cost-effectiveness of physiotherapy for chronic rotator cuff pathology

物理治疗慢性肩袖病理的疗效和成本效益

• 批准号: nhmrc : 299840
• 负责人: Prof Andrew Forbes
• 金额: $ 25.65万
• 依托单位国家: 澳大利亚
• 项目类别: NHMRC Project Grants
• 财政年份: 2004
• 资助国家: 澳大利亚
• 起止时间: 2004-01-01 至 2006-12-31
• 项目状态: 已结题
• 来源: https://researchdata.edu.au/efficacy-cost-effectiveness-cuff-pathology/78338
• 关键词: Efficacy; cost; effectiveness; physiotherapy; chronic

Shoulder disorders are common, being third only to back and neck complaints as musculoskeletal reasons for medical consultation and accounting for 10% of all physiotherapy referrals. The painful shoulder affects up to 2-5% of the general population, being more common in middle to older age. One of the most common shoulder disorders is chronic rotator cuff pathology. This causes significant pain and disability that restricts activities of daily living as well as work, sleep and leisure. Forty percent of sufferers will continue to have symptoms beyond 3 years and 15% will have persistent disability which may require surgical intervention. Because this disorder is prevalent, it imposes a considerable burden on the Australian health care system. Physiotherapy is a common conservative treatment option but its efficacy has not been well established. A recent Cochrane review of the literature revealed several problems with many of the existing studies: (i) the populations have included a mix of shoulder diagnostic categories; (ii) the research designs have major flaws and (iii) a single physiotherapy modality has been evaluated rather than a combined program as is current clinical practice. Thus, this novel research project involving 200 participants will answer important questions about the efficacy of a physiotherapy program for chronic rotator cuff pathology and whether benefits can be maintained. In addition it will determine whether the costs of physiotherapy represent good value for money which is important in today's economic climate. The results of this project can be easily and immediately translated into clinical practice as recommendations can be made about the usefulness of physiotherapy for this patient population. The results will be of major benefit not just to the physiotherapy profession but to the medical profession who must justify patient referral to physiotherapy and to funding and compensable bodies.

肩部疾病是常见的，是第三次仅次于背部和颈部的肌肉骨骼疾病的原因，医疗咨询和占10%的所有物理治疗转诊。肩部疼痛影响高达2-5%的一般人群，在中年至老年人中更常见。最常见的肩关节疾病之一是慢性肩袖病变。这会导致严重的疼痛和残疾，限制日常生活活动以及工作，睡眠和休闲。40%的患者将继续有症状超过3年，15%将有持续的残疾，可能需要手术干预。由于这种疾病很普遍，它给澳大利亚的医疗保健系统带来了相当大的负担。物理治疗是一种常见的保守治疗选择，但其疗效尚未得到充分证实。最近的科克伦文献综述揭示了许多现有研究的几个问题：（i）人群包括肩关节诊断类别的混合;（ii）研究设计有重大缺陷;（iii）评价的是单一的物理治疗方式，而不是当前临床实践中的联合方案。因此，这项涉及200名参与者的新研究项目将回答有关慢性肩袖病理的物理治疗计划的有效性以及是否可以保持益处的重要问题。此外，它还将确定物理治疗的费用是否物有所值，这在今天的经济环境中是很重要的。该项目的结果可以很容易地立即转化为临床实践，因为可以对该患者人群的物理治疗的有用性提出建议。研究结果不但对物理治疗专业，而且对医学专业都有重大的好处，因为医学专业必须证明病人转介接受物理治疗是合理的，并向资助和赔偿机构提出理由。